Introduction: The traumatic rupture of thoracic aorta is a surgical emergency with high risk of morbidity and mortality.
Case report: We describe the case of an atypical rupture of retro-cardiac thoracic aorta with dissection of brachiocephalic trunk and spleen trauma occurred after a road accident. TC scan and perioperative angiography showed an atypical rupture of thoracic aorta.
Conclusion: A combined treatment, endovascular for retro-cardiac thoracic aorta and surgical for brachiocephalic artery, has been useful to diminish the hemodynamic and organ ischemic problems associated with open surgery.